By George W. Chapman

If insurance companies are investing in or partnering with telehealth companies, then you know telehealth or virtual medicine has arrived. Historically, physicians have been somewhat reluctant to embrace telehealth primarily because of low reimbursement. However several factors are contributing to a change of heart including an aging and less mobile population, consumer preference, improved IT security, the continuing shortage of physicians and value or outcome-based reimbursement from Medicare, Medicaid and commercial carriers. CIGNA and Health Care Service Corporation just invested $50 million with telehealth company MDLive, and Anthem has invested $365 million in Samsung and American Well telehealth companies to make virtual visits available on Galaxy mobile phones. Insurance companies are lowering copays and fees for telehealth/virtual visits to cut into expensive and often unnecessary visits to urgent care centers and emergency rooms. They are focused on providing their members with choice, personalization and affordability.

Waiving copays, deductibles and coinsurance for physician services Effective immediately, Cigna is waiving all cost-sharing for in-network medical or behavioral telehealth visits for customers in the U.S. Covered by Medicare Advantage and Individual and Family Plans. Cigna's Clinical Team to Increase Capacity for Virtual Care To provide additional support for the medical community, Cigna will deploy hundreds of on-staff clinicians, including physicians and nurse practitioners, to join the team of health care professionals at MDLIVE, a leading telehealth company and Cigna network partner. Cigna Telehealth Connection Services $25 copay, then your plan pays 100% Not Covered Includes charges for the delivery of medical and health-related consultations via secure telecommunications technologies, telephones and internet only when delivered by contracted medical telehealth providers (see details on myCigna.com).

Senior bankruptcy

Three percent of seniors will file for bankruptcy this year, and it is a steadily increasing percentage of all bankruptcies. There are several factors for this: more people are retiring from companies that no longer provide pensions, credit card debt, bad investments, lack of planning and an unforeseen calamity. But the looming reason behind most senior bankruptcies is medical debt. Medicare covers 80 percent of physician claims and some drug costs. A chronic condition, serious illness, accident and out-of-pocket drug expenses can easily wipeout hard-earned savings.

Cigna Telehealth Copay Card

• Virtual care (also known as telehealth, or telemedicine) is the use of technology to connect with a provider by video or phone using a computer or mobile device. How does virtual care work? Depending on your plan and location, eligible Cigna customers can connect with board-certified medical providers and licensed therapists online using a.
• Visit our Coronavirus Resource Center to find the latest information on COVID-19 for customers, employers, brokers, and health care professionals.

Focus on patients

As the industry transitions to value/outcome based payments, hospitals and physicians are transitioning from being “treatment-centric” entities to “patient centric” entities. Their focus is on attracting, engaging, managing and retaining patients. In order for this to succeed, as patients, we must bear more responsibility for our care. Providers are implementing strategies to make it easier for us to stay in touch, be informed and be proactive versus passive in our care. Patient portals, wearable devices, telehealth, patient education programs, specifically targeted information sent directly to your phone, navigators and digital apps are all there to strengthen the relationship. In addition to a patient focus, healthcare systems must eliminate wasteful practices, many of which were driven by fee-for-service or volume incentives, and rely more on data and analytics to manage their patients and their bottom lines.

Fewer docs feel overworked

According to a recent survey of 3,700 physicians sponsored by two large MD staffing agencies, fewer physicians feel overworked or are considering retiring early compared to just two years ago. While the survey is somewhat heartening, physician burnout is still a serious issue.

• 56 percent of respondents said they feel overworked;

• 55 percent say they have less free time than when they first started practicing;

• 48 percent of physicians said they spend less time with patients now than when they first started;

• 74 percent of the physicians responding said they recognize the signs of burnout in their colleagues;

• 40 percent said burnout effects their job satisfaction and family life;

• Only 17 percent of physicians suffering burnout have sought help.

Cigna Telehealth End Date

The study did not attribute the slight “improvement” in results to anything. One reason for the improvement could be that physicians are getting used to and less frustrated with electronic medical records. Many physicians report spending several hours after work and on weekends keeping their records up.

Market consolidation

Is There A Copay For Telehealth

Bigger is better, especially at the negotiating table. In order to get the upper hand at the negotiating table, hospitals are merging with other hospitals while insurers are merging with other insurers. In order to preserve competition and protect consumers from monopolistic pricing, the Department of Justice must approve and then monitor all mergers. While the common justification for both hospital and insurance mergers is cost reduction, it hasn’t always been the case. The DOJ has split apart mergers when the larger hospital or insurer proceeded to take advantage of their newfound clout in the market and raised prices. According to the Commonwealth Fund, 90 percent of metropolitan statistical areas (MSAs) are either “highly” or “super” concentrated provider (hospital) markets and that 54 percent of MSAs were highly concentrated insurance markets. Provider concentration was higher than insurance concentration in 58 percent of MSAs. Premiums have increased and provider choices have decreased across the board for most Americans, not just those covered by the ACA.

Millennial caregivers

A recent article in the Wall Street Journal presented an alarming trend. As the US population grows older, accelerated by aging baby boomers, the age of the average care giver grows younger. An estimated 6.2 million millennials account for 24 percent of unpaid caregivers, averaging 21 hours a week caring for an elderly parent, grandparent or in-law. One-third of millennials are caring for someone with dementia. By 2050, it is estimated that potential caregivers will increase by only 13 percent while those requiring their care will increase by 160 percent. The places a tremendous personal and financial burden on younger generations who are building their careers and starting their families.

Short-term health plans

Under the Affordable Care Act, short-term plans were limited to just three months. They were offered primarily to bridge the time one had to wait until the next open enrollment period. The Trump administration has recently finalized a rule allowing insurers to offer short-term plans covering 12 months and then renewable for two more years. These purported “affordable plans” do not have to cover pre-existing conditions or the essential health benefits that were the hallmarks of the ACA. So buyer beware. According to HHS Secretary Alex Azar, “Under the ACA, Americans have seen insurance premiums rise and choices dwindle.” The problem with that statement is health insurance premiums have risen and choices have dwindled for all Americans. Just ask any employer that pays for most of the premium. The ACA is simply a microcosm of the entire health insurance industry.

George W. Chapman is a healthcare business consultant who works exclusively with physicians, hospitals and healthcare organizations. He operates GW Chapman Consulting based in Syracuse. Email him at gwc@gwchapmanconsulting.com.

Cigna is eliminating cost-sharing for all primary, specialty and behavioral care for in-office or telehealth visits for all COVID-19 and non-COVID-19 care.

This is for in-network medical or behavioral telehealth visits for customers in the U.S. covered by Medicare Advantage, individual or family plans, including individual plans sold on the marketplace.

Additionally, Cigna is making enhancements to its Medicare Advantage meal plan benefits for customers during the pandemic. The insurer is providing additional days of nutrition through meal delivery for customers following their discharge from a hospital stay for any condition, including COVID-19.

Cigna's Medicare Advantage customers will now have access to 28 meals for 14 days at no extra cost following their discharge from a hospital, which doubles the meals offered previously.

These home-delivered meals incorporate individual dietary restrictions, and are delivered frozen with preparation instructions.

For Cigna's Medicare Advantage customers, these cost-share measures, benefits extensions and policy changes will be in effect through the end of December 2020. For individual and family plans and exchange customers, these changes will apply until the end of applicable federal and state public health emergencies.

WHY THIS MATTERS

While telehealth is not suitable for every condition, it is important for people not to defer critical care needs at this time, Cigna said.

In May, the Centers for Medicare and Medicaid Services finalized requirements that increased access to telehealth for seniors in Medicare Advantage plans. The agency provided more flexibility for telehealth providers in specialty areas.

THE LARGER TREND

Cigna previously eliminated cost share for COVID-19 testing and treatment.

Telehealth Cigna Coverage Policy

These measures are an expansion of Cigna's previously-announced efforts during COVID-19.

Cigna followed CMS's lead by reimbursing providers for COVID-related virtual visits as if they were in-person visits. It also eased primary care provider referrals for specialists in certain situations.

Customers who were eligible to pick a Medicare Advantage plan earlier this year, but could not because of the pandemic, are entitled to a special enrollment period.

Additionally, individuals who lost healthcare coverage from their employer, or had other significant life events, are entitled to a special enrollment period for individual health plans.

Cigna Telehealth Policy 2020

ON THE RECORD

'COVID-19 has affected all age groups – physically, financially and emotionally,' said Brian Evanko, president of Cigna's Government Business. 'We want everyone to focus on getting and staying well – including those being tested for and diagnosed with the virus and their loved ones – and not having to worry about how they will access or afford the care and services they need.'

'For many customers, virtual care is an effective way to address their health concerns and continue to access their medications without leaving the safety of their homes,' said Dr. Gina Conflitti, chief medical officer of Cigna's Medicare Advantage business. 'By waiving cost sharing for these behavioral health visits, in addition to medical services, we're making it easier and more affordable for customers to attend to both their mental health and physical well-being in a setting that works best for their individual needs.'

Twitter: @SusanJMorse
Email the writer: susan.morse@himssmedia.com